Antibacterial properties and side effects of chlorhexidine-based mouthwashes. A prospective, randomized clinical study

  • E. Polizzi
  • G. Tetè | DDS, Specialization School in Oral Surgery, Vita-Salute San Raffaele University, Milan, Italy, Italy.
  • F. Bova
  • G. Pantaleo
  • G. Gastaldi
  • P. Capparè
  • E. Gherlone


Aim Chlorhexidine (CHX) is commonly used in clinical applications, including plaque control and gingivitis treatment. The im of this study was to evaluate the clinical properties, in terms of plaque control, bleeding and discoloration levels, of six CHX mouthwashes that differ in the following characteristics: CHX concentration, presence/absence of alcohol and presence/absence of an anti-discoloration system (ADS).

Materials and methods A single-center, prospective, double-blind randomized clinical trial was carried out on 78 consecutive patients. Six mouthwashes (CHX 0.12% alcohol free; CHX 0.20% alcohol free; CHX 0.12% alcohol free with ADS; CHX 0.20% alcohol free with ADS; CHX 0.12% with alcohol; CHX 0.20% with alcohol) were tested. Plaque Index (PI) and Bleedind Index (BI) were recorded, along with tooth staining (spectrophotometry) at T0 (beginning), at T1 (after 7 days), at T2 (after 14 days), and T3 (after 21 days). Data obtained were subjected to statistical analysis.

Results All CHX mouthwashes significantly reduced PI (p<0.0001), while only alcohol free CHX 0.20% significantly reduced BI (p<0.0001). Only the CHX 0.12% with alcohol and CHX 0.20% with alcohol mouthwashes showed a significant presence of extrinsic tooth staining (p<0.05).

Conclusions Within the limitations of the present study, the alcohol-free mouthwash CHX 0.20% allows a good control of the clinical indices, in particular the bleeding index. 


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Chlorhexidine, Mouthwashes, Oral cancer, Tooth staining
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How to Cite
Polizzi, E., Tetè, G., Bova, F., Pantaleo, G., Gastaldi, G., Capparè, P., & Gherlone, E. (2019). Antibacterial properties and side effects of chlorhexidine-based mouthwashes. A prospective, randomized clinical study. Journal of Osseointegration, 12(1), 2-7.